Single-nucleotide promoter polymorphism of angiotensin II type 1 receptor gene AGTR1 affects to sepsis course and outcome in patients with diabetes

Abstract

Dysregulation of blood pressure significantly impacts the course and outcome of sepsis. The AGTR1 gene encodes angiotensin II receptor type 1, which affects the vascular tone and contributes to septic shock. Our study aims to define whether the AGTR1 polymorphism contributes to the course and outcome of sepsis. The study included patients (n=286) from three ICU (Intensive Care Unit) aged 18-92 years with sepsis. In all patients (n=286) with sepsis the incidence of septic shock differed depending on AGTR1 genotype: carriers of the AGTR1 TT genotype had a less incidence of septic shock compared with patients with the AGTR1 AT, AA genotypes (60% vs. 73%, P = 0.47, FET (Fisher`s Exact Test), OR=1.8, 95% CI: 1.1-3.3). In group of patients with diabetes mellitus (n=79), we also found differences in sepsis course and outcome based on the AGTR1 rs275651 genotypes. The subgroup of TT AGTR1 rs275651 genotype carriers demonstrated significantly lower mortality compared with TA, AA genotypes carriers (60 % vs. 88 %, Р=0,018, OR=5,0, 95% CI: 1,34 -18,9, FET). The incidence of septic shock was also less in AGTR1 TT genotype-carriers in subgroup patients with diabetes (57% vs 92%, P=0,02, OR=9,2, 95 % CI: 1.97-42.9, FET). We found an association of the functional polymorphism AGTR1 rs275651 with course and outcome of sepsis in ICU patients with diabetes mellitus: carriers of the more common TT genotype had less incidence of septic shock and lower mortality compared to carriers of the minor A allele.